POS0020 DOES SUBJECTIVELY PERCEIVED LOSS OF HAND FUNCTION SUFFICIENTLY REPRESENT ULTRASONOGRAPHY-DETECTED SYNOVITIS AND TENOSYNOVITIS IN PATIENTS WITH PSORIASIS AND PSORIATIC ARTHRITIS?
Authors: B. Coppers, S. Bayat, E. T. Godonou, L. Valor, D. Simon, F. Fagni, G. Corte, K. Tascilar, A. Hueber, V. Schönau, M. Sticherling, G. Schett, A. Kleyer, A. M. Liphardt
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> In the clinical routine patient reported outcome measures (PROMs) such as the 'Disability of the Arm, Shoulder and Hand Questionnaire' (Quick-DASH) [1], 'Score for the Assessment and quantification of Chronic Rheumatic Affections of the Hands' (SF-SACRAH) [2] and the ´Health Assessment Questionnaire´ (HAQ) [3] are common for assessing functional status and hand involvement in rheumatic diseases [4] while ultrasonography (US) is a cost-effective, reliable imaging technology for grading and monitoring synovitis and tenosynovitis [5]. However, it is unclear, if subjective perceived impairment can be associated with US-detected synovitis or tenosynovitis in patients with psoriatic arthritis (PsA) and psoriasis (Pso). <h3>Objectives</h3> To correlate subjective hand function with the grade of synovitis and tenosynovitis by US (greyscale (GS), power Doppler (PD) activity) in patients with PsA and Pso. <h3>Methods</h3> PsA and Pso patients recruited from the Rheumatology Department at the University Hospital Erlangen were enrolled in this cross-sectional study after giving written informed consent. Patients completed the HAQ-DI, SF-SACRAH and Quick-DASH questionnaires and subject characteristics (age, sex, disease) were recorded. The examining physician performed a bilateral US (Samsung HS40, South Korea; Esaote Mylab Twice, Italy) of the flexor tendons of all fingers and metacarpophalangeal (MCP) joints 2-5 and both wrists. Each joint was examined by GS (score 0-3) and PD (score 0-3) and flexor tendons were scanned in GS (0/1) and with PD (0-3) following the EULAR-OMERACT scoring system [5]. For statistical analysis patients with either a positive synovitis or tenosynovitis score ≥1 were included. A repeated measure correlation analysis was performed, at the intra-individual level, to measures the overall strength and direction of the linear relationship between the PROMs with US scores. <h3>Results</h3> A total of 106 patients (40 PsA/66 Pso: age 47.5(12.3)/43.6(14.1) years, 63%/61% male) participated in this study. US-activity is listed in Table 1. Moderate positive correlations were detected for GS tenosynovitis score in digit 1 with both, Quick-DASH (r=0.352, p=0.038) and HAQ-DI (r=0.399, p=0.036) and also for GS tenosynovitis score in digit 4 with Quick-DASH (r=0.354, p=0.037). Overall GS synovitis score (MCP 2-5 + wrist) shows a moderate negative correlation with Quick-DASH (r=-0.323, p=0.031) and HAQ-DI (r=-0.477, p=0.002), as does PD tenosynovitis score in digit 1 (r=-0.386, p=0.022) and 3 (r=-0.386, p=0.022) with SF-SACRAH. HAQ-DI, SF-SACRAH and Quick-DASH correlated strongly with each other (r&gt;0.7, p&lt;0.001). <h3>Conclusion</h3> Only the grade of chronic tenosynovitis is partially represented in Quick-DASH and HAQ-DI, while synovitis scores are negatively related to them. Surprisingly, worse hand function detected by the most hand-specific questionnaire, SF-SACRAH, was associated with less acute tenosynovitis. While Quick-DASH and HAQ-DI focus on tasks which require sufficient hand strength, the SF-SACRAH focuses on activities demanding fine motor skills, which seems to be less affected by tenosynovitis. Varying correlations of the different PROMs with the US scores have already been described for patients with rheumatoid arthritis [6]. Subjectively perceived hand function does not sufficiently reflect grade of synovitis and tenosynovitis and therefore more sensible functional outcome parameters are required. <h3>References</h3> [1]Franchignoni F et al <i>J Orthop Sports Phys Ther 2014</i> [2]Rintelen B et al <i>Osteoarthritis Cartilage 2009</i> [3]Maska L et al <i>Arthritis Care Res 2011</i> [4]Kucukdeveci A A et al <i>RMD Open 2021</i> [5]D'Agostino M A et al <i>RMD Open 2017</i> [6]Ozer P K et al <i>Indian J Med Res 2017</i> <h3>Acknowledgements</h3> This work was partly funded by Novartis Pharma GmbH, Germany and the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – SFB 1483 – Project-ID 442419336, EmpkinS. <h3>Disclosure of Interests</h3> Birte Coppers: None declared, Sara Bayat: None declared, Elie Tino Godonou: None declared, Larissa Valor: None declared, David Simon: None declared, Filippo Fagni: None declared, Giulia Corte: None declared, Koray Tascilar: None declared, Axel Hueber: None declared, Verena Schönau: None declared, Michael Sticherling: None declared, Georg Schett: None declared, Arnd Kleyer: None declared, Anna-Maria Liphardt Grant/research support from: Novartis Pharma GmbH, Germany.